Beating heart cardiac surgery without cardiopulmonary bypass, also called off-pump coronary artery bypass (OPCAB) surgery, has gained more popularity in recent years. Even with limited evidence from prospective studies, published data suggest fewer complications normally associated with cardiopulmonary bypass (e.g., renal dysfunction, neurologic disorders, systemic inflammatory response syndromes) . With the use of new technology like improved stabilizer and exposure systems, all sides of the heart can be reached and multivessel revascularization procedures can be performed. The surgical goals are summarized in Table 1 . This increasing popularity has challenged the daily work of cardiovascular anesthesiologists. This article describes our approach to OPCAB procedures, the way we handle pitfalls and complications and may suggest a different attitude towards OPCAB surgery, always stressing the paramount subject: communication between anesthesiologist and surgeon.
KeywordsMean Arterial Pressure Anesthetic Management Activate Coagulation Time Atrial Pace Left Internal Mammary Artery
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